Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 10235 | MS |
Y | 207Q00000X | Family Doctor | 10235 | MS |
NPI | 1013026970 |
---|---|
Provider Name | John C Adams |
First Address | Augusta, AR 72006-0497 |
Second Address | Pontotoc, MS 38863-1103 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00017133 | (05) | MS |
0017133 | (05) | MS |
D83876 | (02) | |
D83876 | (02) | MS |